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<br />Pol,'Y Numb". CA000003653-05 <br /> <br />CG 20 100704 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />Effe..:tlve D;tle- 04/01105 <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZA TION <br /> <br />This endorst:ment modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LlABlLlTY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name or Additionollnsured Person(s) <br />Or Or2snization(s): <br /> <br />SEE BELOW <br /> <br />Location(s) Of Covered Oocrations <br /> <br />I <br />I <br />I <br /> <br />InformatIon rcnuired to complete this Schedule. if nOI :::.hown Jbuve, will be shown in the Ded;lr':l.!luns. <br /> <br />A. Section II - Who Is An Insured is amended to <br />include as an addltion,)l insured lr.e pers:..lO(s) or <br />urganizalion(s) sho..." in the Schedule, but only with <br />respect (() liilbdily for "bodily injury", "properly <br />damage"" or "personal and advertising injury" cJ.used, <br />in whole or in part, by: <br /> <br />1. Your ;lets or omi~~ion~: or <br /> <br />2. The <leIS or tlmis~ion!> nltnose acting on your <br />bch<llf; <br /> <br />In the performance of YQur ongoing operation~ for the <br />addllional insured(s) at the locution(s) designated <br />above, <br /> <br />B. With respect tu lhe Insurance affUllletl to these <br />additional insureds. the following additional <br />exclusiom apply: <br /> <br />This insur<lncc docs nol :.lpply :0 "boolly injury" or <br />"propeny dam<lgc" nl.:curring ..fn:r: <br /> <br />1. All work. including matt;n.lls, parrs or cquil'fncn: <br />furnished in COnnCl..'tlon wuh such work. 011 the <br />project (other than serVlce. maintenance or <br />rc:pairs} to be perfor.'ned by or on hch:M of the <br />additionallnsured(s) at the location of L'1e <br />cuvc:red nperalions has been completed, or <br /> <br />2. Thai portion of "yoU\' work" Dut ot which the <br />injury or damage ari~es has been put 10 ib <br />inl~nded u~c by any person or org"miL.ltion othel <br />than another COnlractnr or suhconlractor engilged <br />in performing operatIOns for a princi~.d as u pan <br />of the same pruje~L. <br /> <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701; its officers, employees, agents, volunteers <br />and representatives are named as additional insureds with regards to liability and defense of suits arising from <br />the operations and uses performed by or on behalf of the named insured, <br /> <br />APPROVED AS TO FORM <br /> <br />p:/} 7-13 <br />La~ra SlltL Sl1CGdy <br />t\SSlsUlllt City AII,1rll(:\ <br /> <br />CG ZIll007 04 <br /> <br />@ ISO Properlie:>, Ine '. 2004 <br /> <br />Page 1 of I <br /> <br />o <br />